Synergistic effects of interferon‐beta and nivolumab in oral mucosal melanoma

Abstract

Mucosal melanoma is a rare aggressive cancer with a very poor prognosis. Clinical and pathological characteristics of mucosal melanoma differ from those of cutaneous melanoma and there are no established management guidelines for mucosal melanoma. Complete surgical excision is one of the most effective treatments for localized lesions, while targeted therapies and immunotherapies, such as monoclonal antibodies that target cytotoxic T-lymphocyte-associated molecule-4, and the programmed death (PD)-1/PD-ligand 1 pathway inhibitors, are treatment options for unresectable or metastatic lesions. Here, we describe the case of a patient with oral mucosal melanoma with multiple metastases. In our case, local injection of interferon (IFN)-b with dacarbazine-nimustinevincristine therapy provided antitumor effects on an invasive tumor on the upper gingiva. Nivolumab therapy produced complete remission of lymph node and bone metastases. In contrast, the remaining in situ portion of oral mucosal melanoma on the hard palate was refractory to IFN-b monotherapy and nivolumab therapy. However, after administration of nivolumab, peritumoral injection of IFN-b showed rapid therapeutic effects. Our case suggested that nivolumab upregulated the antitumor effects of IFN-b, which induced the recruitment of CD8 + T cells into the tumor microenvironment contributing to the deletion of tumor cells. Combination therapy of IFN-b and nivolumab may be a potential treatment option for patients with oral mucosal melanoma.

Treatment modalities in sinonasal mucosal melanoma: A national cancer database analysis

“…22 In another case report of a patient with metastatic oral mucosal melanoma, Fusumae et al administered a combination therapy of interferon-β and nivolumab, another anti-PD1 antibody; the patient underwent complete remission of lymph node and distant metastases. 23 Thus, our finding that immunotherapy is a significant predictor of improved survival in patients with distant metastases, in conjunction with the results of these clinical trials, warrants further clinical investigation of immunotherapy efficacy in SNMM patients.…”

Mucosal melanoma — clinical presentation and treatment based on a case series

“…New treatment methods for mucosal melanoma include combinations of immunotherapies, or immunotherapies and local therapies. Single examples of effective peritumoral injections with b-interferon (IFN-b) and interleukin 2 (IL-2) in combination with nivolumab have been reported [33,34]. Targeted treatment, including that with the use of BRAF/MEK or KIT inhibitors (imatinib), may be considered in the carriers of adequate mutations [35].…”